Reduction In Body Mass Index Research Articles

Effect of high-intensity interval training vs. moderate-intensity continuous training on cardiometabolic risk factors in overweight and obese individuals.

Our study aims to compare the effects of an 8-week high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) on cardiometabolic risk factors and on serum leptin levels in overweight and obese individuals. Our quasi-experimental study involved 36 students who were assigned to HIIT, MICT or the control group. Using a bicycle ergometer, participants in the HIIT group performed 25 min of HIIT and those in the MICT group performed 35 min of moderate-intensity continuous exercise for three days a week for 8weeks. Body composition estimated by bioimpedance analysis, blood lipids and serum leptin were measured pre-exercise and 8weeks post-exercise. After 8weeks of exercise, the participants in the MICT group showed a significant reduction in weight (p<0.01) and body mass index (BMI) (p<0.05). In the HIIT group, although weight reduction was noticed, the difference was not statistically significant compared to the pre-exercise values. In the control group, participants had a significant increase in their weight, BMI, and total body fat (p<0.05). On performing an inter-group comparison of the magnitude of change in body weight and BMI over 8weeks of exercise, no difference was seen between the HIIT and MICT groups. No difference was observed in body fat indices and levels of random blood glucose, blood lipids and serum leptin pre and 8weeks post-exercise. On comparing the change in body weight and BMI over 8weeks, no significant difference was found between the HIIT and MICT groups. However, HIIT was notably more time efficient.

The effects of chicory inulin-type fructans supplementation on weight management outcomes: systematic review, meta-analysis, and meta-regression of randomized controlled trials

BackgroundExcess body weight and adiposity can adversely affect metabolic health. Prebiotics such as inulin-type fructans (ITFs) from chicory root are known to modulate gut microbiota and may improve body weight regulation. ObjectivesThis study aimed to assess evidence for chicory ITF supplementation to support weight management. MethodsEligible articles (initial search to 2021, updated to February 2023) were searched from EMBASE, MEDLINE (PubMed), and Cochrane Library. Data on primary (body weight) and secondary outcomes [body mass index (BMI), total fat mass, body fat percentage, and waist circumference] were extracted by 2 reviewers independently. Random-effects model using inverse-variance method was used. Subgroup analysis (health status and ITF type) and meta-regression (dose and duration) were evaluated. ResultsA total of 32 eligible studies were included. Chicory ITF significantly reduced body weight [mean difference (MD): −0.97 kg; 95% CI: −1.34, −0.59); n = 1184] compared with placebo. ITF favored overall effects reduction in BMI (MD: −0.39 kg/m2; 95% CI: −0.57, −0.20; n = 985), fat mass (MD: −0.37 kg; 95% CI: −0.61, −0.13; n = 397), waist circumference (MD: −1.03 cm; 95% CI: −1.69, −0.37; n = 604), and for intervention duration of >8 wk, body fat percentage (MD: −0.78%; 95% CI: −1.17, −0.39; n = 488). Except for considerable heterogeneity in body weight (I2: 73%) and body fat percentage (I2: 75%), all other outcomes had negligible to moderate heterogeneity. Significant reduction in body weight, BMI, and waist circumference was evident irrespective of participants' health status. There was minimal evidence that dose, duration, or type of ITF influenced the magnitude of reductions in outcomes. ConclusionsChicory ITF supplementation may benefit weight management by reducing body weight, BMI, fat mass, waist circumference, and, to a certain extent, body fat percentage.This systematic review with meta-analysis was registered at PROSPERO as CRD42020184908.

Use of liraglutide after bariatric surgery: a 36-month follow-up in a real-world setting in Chile.

Bariatric surgery has several benefits, including sustainable weight loss and improvement or resolution of metabolic comorbidities. However, despite initially successful weight loss, weight regain occurs during long-term follow-up, and many patients are unable to reach or maintain their target weight goals. Liraglutide is a therapy for obesity aimed at preventing weight regain. This retrospective, observational, single-arm, pre-post study was performed to analyze the relative change in body weight among patients receiving liraglutide after bariatric surgery in a real-world setting in Chile. Treatment with liraglutide at a median dose of 1.2 mg was associated with a mean weight loss from baseline to 3, 6, 12, 24, and 36 months of 5%, 7.7%, 7.6%, 5.8%, and 5.1%, respectively. The mean body mass index reduction was 14.8% at 36 months. Dropout rates were consistent with those of usual obesity treatments. Overall, 70% of the patients were receiving other weight-loss drugs. Liraglutide was well tolerated, but cost barriers led to several patients interrupting its use. Liraglutide is an effective and safe treatment for weight reduction after bariatric surgery in patients receiving routine clinical care in Chile.

Long-Term Change in BMI for Children with Obesity Treated in Family-Centered Lifestyle Interventions

Introduction: Several evaluations of lifestyle interventions for childhood obesity exist; however, follow-up beyond 2 years is necessary to validate the effect. The aim of the present study was to investigate long-term weight development following children participating in one of two pragmatic family-centered lifestyle interventions treating childhood obesity. Methods: This real-life observational study included Danish children 4–17 years of age classified as having obesity. Data from 2010 to 2020, from two community-based family-centered lifestyle interventions (designated hereafter as the Aarhus- and the Randers-intervention) were merged with national registers and routine health check-ups, including height and weight. Adjusted mixed effect models were used to model changes in body mass index (BMI) z score. We performed exploratory analyses of the development in BMI z-score within stratified subgroups of children treated in the interventions before investigating potential effect modifications induced by sex, age, family structure, socioeconomic, or immigration status. Results: With a median follow-up of 2.8 years (interquartile range: 1.3; 4.8), 703 children participated in an intervention (445 the Aarhus-intervention; 258 the Randers-intervention) and 2,337 children were not invited to participate (no-intervention). Children in both interventions experienced a comparable reduction in BMI z-scores during the first 6 months compared to the no-intervention group (Aarhus-intervention: −0.12 SD/year and Randers-intervention: −0.25 SD/year). Only children in the Randers-intervention reduced their BMI z-score throughout follow-up (Aarhus-intervention vs. no-intervention: 0.01 SD/year; confidence interval [CI]: −0.01; 0.04; Randers-intervention vs. no-intervention: −0.05 SD/year; CI: −0.08; −0.02). In subgroup comparisons, combining the two interventions, family income below the median (−0.05 SD/year, CI: −0.02; −0.09), immigrant background (0.04 SD/year, CI: 0.00; 0.07), or receiving intervention less than 1 year (0.04 SD/year, CI: 0.00; 0.08) were associated with a yearly increase in BMI z score. In addition, effect modification analyses did not observe any interaction by sex, age, family structure, socioeconomic, or immigration. Conclusions: Although the more dynamic intervention with longer duration obtained and sustained a minor reduction in BMI z score, the clinical impact may only be modest and still not effective enough to induce a long-term beneficial development in BMI in children with obesity.

Anti-Obesity Medication in the Management of Children and Adolescents With Obesity: Recent Developments and Research Gaps.

Paediatric obesity is a global public health concern. While in most countries the incidence keeps rising, the need for effective and long-term management for children and adolescents living with this chronic, relapsing disease is pressing. Health behaviour and lifestyle treatment (HBLT) is recommended as first-line treatment. Narrative review. A new generation of recently approved anti-obesity medications (AOM) now has the potential to fill the gap between limited effects on body mass index (BMI) by HBLT alone and large effects by metabolic and bariatric surgery in adolescents with obesity aged 12 years and older. While, for semaglutide and phentermine/topiramate, effectiveness is substantial with relevant, but mostly mild to moderate adverse events, there is a gap in evidence regarding long-term effects and safety, effects on outcomes beyond BMI reduction and data for certain groups of patients, such as children < 12 years and minority groups. When integrating AOM treatment into national healthcare systems it should be offered as part of a comprehensive patient-centred approach. This article summarizes recent AOM developments, integration into paediatric obesity management, and identifies research gaps.

Real-world evaluation of the effects of tirzepatide in patients with type 2 diabetes mellitus.

Tirzepatide is a first-in-class combination glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and glucagon-like peptide 1 receptor agonist (GLP1-RA) approved for treatment of adults with type 2 diabetes mellitus (T2DM) and chronic weight management. The aim of this analysis was to assess the real-world efficacy of tirzepatide in patients with T2DM. This retrospective observational study evaluated patients with T2DM from a large urban academic medical centre who received at least 3 months of continuous tirzepatide treatment. The primary outcome was change in A1C from following tirzepatide treatment. Secondary outcomes included change in body weight and body mass index (BMI) after tirzepatide was initiated. A total of 1896 patient charts were reviewed, and 612 patients were evaluated for the primary outcome. Over a median time period of 10.4 months, treatment with tirzepatide resulted in a mean A1C reduction of 1.02 ± 1.48% (p < 0.001). A total of 570 patients were evaluated for the secondary outcomes. Tirzepatide was associated with a mean reduction in body weight of 7.3 ± 9.3 kg (p < 0.001) and a mean reduction in BMI of 2.5 kg/m2. Greater A1C lowering and weight loss was observed in patients without prior GLP1-RA treatment compared to those switched to tirzepatide from GLP1-RA. In a real-world population of US patients with T2DM, tirzepatide was associated with clinically and statistically significant reductions in A1C and body weight. Greater reductions in both A1C and body weight were observed among patients who were GLP1-RA naïve compared to patients switched from GLP1-RA to tirzepatide.

A Starch- and Sucrose-Reduced Diet Has Similar Efficiency as Low FODMAP in IBS-A Randomized Non-Inferiority Study.

A diet with low content of fermentable oligo-, di-, and monosaccharides and polyols (FODMAP) is established treatment for irritable bowel syndrome (IBS), with well-documented efficiency. A starch- and sucrose-reduced diet (SSRD) has shown similar promising effects. The primary aim of this randomized, non-inferiority study was to test SSRD against low FODMAP and compare the responder rates (RR = ∆Total IBS-SSS ≥ -50) to a 4-week dietary intervention of either diet. Secondary aims were to estimate responders of ≥100 score and 50% reduction; effects on extraintestinal symptoms; saturation; sugar craving; anthropometric parameters; and blood pressure. 155 IBS patients were randomized to SSRD (n = 77) or low FODMAP (n = 78) for 4 weeks, with a follow-up 5 months later without food restrictions. The questionnaires Rome IV, IBS-severity scoring system (IBS-SSS), and visual analog scale for IBS (VAS-IBS) were completed at baseline and after 2 and 4 weeks and 6 months. Weight, height, waist circumference, and blood pressures were measured. Comparisons were made within the groups and between changes in the two groups. There were no differences between groups at baseline. The responder rate of SSRD was non-inferior compared with low FODMAPs at week 2 (79.2% vs. 73.1%; p = 0.661;95% confidence interval (CI) = -20-7.2) and week 4 (79.2% vs. 78.2%; p = 1.000;95%CI = -14-12). Responder rate was still high when defined stricter. All gastrointestinal and extraintestinal symptoms were equally improved (p < 0.001 in most variables). SSRD rendered greater reductions in weight (p = 0.006), body mass index (BMI) (p = 0.005), and sugar craving (p = 0.05), whereas waist circumference and blood pressure were equally decreased. Weight and BMI were regained at follow-up. In the SSRD group, responders at 6 months still had lowered weight (-0.7 (-2.5-0.1) vs. 0.2 (-0.7-2.2) kg; p = 0.005) and BMI (-0.25 (-0.85-0.03) vs. 0.07 (-0.35-0.77) kg/m2; p = 0.009) compared with baseline in contrast to non-responders. Those who had tested both diets preferred SSRD (p = 0.032). In conclusion, a 4-week SSRD intervention was non-inferior to low FODMAP regarding responder rates of gastrointestinal IBS symptoms. Furthermore, strong reductions of extraintestinal symptoms were found in both groups, whereas reductions in weight, BMI, and sugar craving were most pronounced following SSRD.

Exploring the Impact of Swimming on Body Mass Index and Body Fat in Individuals with Down Syndrome: A Meta-Analysis

The aim of this study is to assess the effectiveness of swimming training in reducing body mass index (BMI) and body fat percentage among individuals with Down syndrome (DS), utilizing a meta-analysis approach. We conducted a systematic search for studies examining the clinical impact of swimming training on individuals with DS. Inclusion criteria encompassed studies involving DS patients who underwent swimming training for a minimum duration of 4 weeks. The primary focus was to compare changes in BMI and body fat percentage from baseline to post-training. Our analysis incorporated four studies comprising a total of 48 participants. The results demonstrated that swimming training lasting from 8 to 36 weeks did not significantly decrease BMI among DS patients, with a weighted mean difference (WMD) post-training of −0.428 (95% confidence interval (CI): −1.721–0.865) and an I2 of 0%. Subgroup analysis based on age or duration (≥33 weeks or 8 weeks) also showed no notable decrease in BMI. Conversely, the analysis of body fat percentage demonstrated a significant decrease, with a WMD of −2.946 (95% CI: −5.056–−0.837). Subgroup analysis indicated a consistent reduction in body fat percentage across all duration groups. Swimming training does not lead to a significant reduction in BMI among individuals with DS. This outcome may be attributed to concurrent muscle gain alongside decreased body fat, resulting in a notable decrease in body fat percentage.

Body Mass Index Improvement Reduces Total Knee Arthroplasty Complications Among Patients Who Have Extreme, but Not Severe, Obesity

BackgroundWhile morbid obesity has been associated with increased complication risk in primary total knee arthroplasty (TKA), limited evidence is available to attribute decreased surgical complication rates with body mass index (BMI) reduction. MethodsWe retrospectively assessed 464 unilateral TKAs performed in morbidly obese patients, including 158 extremely obese (BMI ≥ 45) and 306 severely obese patients (BMI 40 to 44.9). A detailed medical record review identified concurrent modifiable risk factors and successful preoperative BMI reduction, reaching either a contemporary risk target (BMI < 40) or an institutionally accepted threshold (BMI < 45). Postoperative blood glucose levels and 1-year adverse outcomes (periprosthetic joint infection, wound dehiscence, knee manipulation, periprosthetic fracture) were compared to 557 contemporary control subjects with expected slightly lower (moderate obesity, BMI 35 to 39.9) or sufficiently lower complication risk (overweight, BMI 25 to 29.9). ResultsPeriprosthetic joint infection and postoperative hyperglycemia were identified more frequently among morbidly obese patients in comparison with a moderately obese control group. Extremely obese patients (BMI ≥ 45) whose BMI improved below 45 had no measurable difference in infection risk from the control group (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.04 to 16.88), while those with a nonimproved BMI had a significantly higher risk (OR 7.70, 95% CI 1.89 to 31.41). No significant differences in the risk for infection were observed between severely obese patients (BMI 40 to 44.9) with preoperative BMI improvement (1.5% rate, OR 1.70, 95% CI 0.17 to 16.57) or nonimprovement (1.7% rate, OR 1.87, 95% CI 0.41 to 8.43). ConclusionsPreoperative medical optimization may decrease postoperative TKA complications. The findings of this study support BMI improvement for extremely obese patients (BMI ≥ 45). The assignment of 40 BMI as a threshold for otherwise healthy patients may exclude patients from potential surgical benefits without realizing risk reduction.

The Release of Lipolytic Hormones during Various High-Intensity Interval and Moderate-Intensity Continuous Training Regimens and Their Effects on Fat Loss.

To investigate the release of lipolytic hormones during various high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), and their effects on fat loss. 39 young women categorized as obese (with a body fat percentage (BFP) ≥30%) were randomly allocated to one of the following groups: all-out sprint interval training (SIT, n =10); supramaximal HIIT (HIIT120, 120%V̇O2peak, n = 10); HIIT (HIIT90, 90%V̇O2peak, n = 10), or MICT, (60%V̇O2peak, n = 9) for a twelve-week observation period consisting of 3 to 4 exercise sessions per week. Serum epinephrine (EPI) and growth hormone (GH) were measured during the 1st, 20th, and 44th training sessions. Body weight (BW), body mass index (BMI), whole-body fat mass (FM) and BFP were assessed pre- and post-intervention. Following the 1st and 20th sessions, significant increases in EPI (p < 0.05) were observed post-exercise in HIIT120 and HIIT90, but not in SIT and MICT. In the 44th session, the increased EPI was found in SIT, HIIT120, and HIIT90, but not in MICT (p < 0.05). For the GH, a significant increase was observed post-exercise in all groups in the three sessions. The increased EPI and GH returned to baselines 3 hours post-exercise. After the 12-week intervention, significant reductions in FM and BFP were found in all groups, while reductions in BW and BMI were only found in the SIT and HIIT groups. Greater reductions in FM and BFP, in comparison to MICT, were observed in the SIT and HIIT groups (p < 0.05). 12-week SIT, HIIT120, and HIIT90, in comparison to MICT, were more efficacious in fat reduction in obese women, partly benefiting from the greater release of lipolytic hormones during training sessions.

Elucidating the role of weight loss and glycaemic control in patients with type 2 diabetes.

To investigate the independent contributions of glycated haemoglobin (HbA1c) reduction and weight loss to clinical outcomes in patients with type 2 diabetes (T2D) treated with antidiabetic drugs, including glucagon-like peptide-1 receptor agonists (GLP-1RAs). This observational, retrospective cohort study used deidentified electronic health record-derived data from patients evaluated at the Cleveland Clinic (1 January 2000-31 December 2020). Cohort A included 8876 patients with newly diagnosed T2D treated with any of six antidiabetic drug classes. Cohort B included 4161 patients with T2D initiating GLP-1RA treatment. The effects of body mass index (BMI) and HbA1c reduction, variability, and durability on clinical outcomes were investigated. In Cohort A, each 1% BMI reduction was associated with 3%, 1%, and 4% reduced risk of heart failure (p = 0.017), hypertension (p = 0.006), and insulin initiation (p = 0.001), respectively. Each 1% (~11 mmol/mol) HbA1creduction was associated with 4% and 29% reduced risk of hypertension (p = 0.041) and insulin initiation (p = 0.001), respectively. In Cohort B, each 1% BMI reduction was associated with 4% and 3% reduced risk of cardiovascular disease (p = 0.008) and insulin initiation (p = 0.002), respectively. Each 1% (~11 mmol/mol) HbA1c reduction was associated with 4% and 16% reduced risk of chronic kidney disease (p = 0.014) and insulin initiation (p = 1 × 10-4), respectively. Lower BMI variability and greater BMI durability were associated with decreased risk of clinical outcomes in both cohorts. Antidiabetic medication-associated, and specifically GLP-1RA-associated, weight loss and HbA1c reductions independently reduce real-world clinical outcome risk.

Efficacy and safety of duodenal-jejunal bypass liner for obesity and type 2 diabetes: A systematic review and meta-analysis.

This study aimed to evaluate the efficacy and safety of duodenal-jejunal bypass liner (DJBL) for obesity and type 2 diabetes mellitus. A comprehensive search of electronic databases was conducted up to September 15, 2022. Thirty studies involving 1751 patients were included. At 12 months post-implantation, the reduction in body mass index (BMI) was 4.8 kg/m2 (95% CI 4.1, 5.5), with an excess weight loss of 41.3% (95% CI 33.4%,49.2%) and a total weight loss of 13.1% (95% CI 10.1%, 16.0%). Significant decrease was observed in HbA1c and fasting glucose, with a standardized mean difference of - 0.72 (95% CI - 0.95, - 0.48) and - 0.62 (95% CI - 0.82, - 0.42), respectively. However, these improvements in weight loss and glycemic control were only partially sustained after explantation. In situ, DJBL significantly improves blood pressure and lipid levels. The pooled early removal rate was 19%, and the incidence of severe adverse events was 17%, including device migration (6%), gastrointestinal hemorrhage (4%), device obstruction (4%), and hepatic abscess (2%). DJBL offers significant improvement in weight loss and glycemic control, as well as cardiovascular parameters while in situ. Further studies are warranted to better understand the long-term efficacy and safety of DJBL. The benefits of DJBL need to be carefully weighed against the risks in clinical decision-making.

Effects of Continuous Prenatal Low Dose Rate Irradiation on Neurobehavior, Hippocampal Cellularity, Messenger RNA and MicroRNA Expression on B6C3F1 Mice.

Epidemiological, experimental, and ecological data have indicated the controversial effect of in utero chronic low dose rate (<6 mGy/h) with accumulative low (≤100 mGy) or high (>100 mGy) dose radiation exposure. Our main goal of this study was to examine if different low dose rates of chronic pre- and/or post-natal radiation exposure with accumulative high doses could induce hippocampal cellular, mRNA, and miRNA changes leading to neuropsychiatric disorders. The comprehensive mouse phenotypic traits, organ weight, pathological, and blood mRNA and miRNA changes were also studied. Using different approaches including SmithKline, Harwell, Imperial College, Royal Hospital, Phenotype Assessment (SHIRPA), neurobehavioral tests, pathological examination, immunohistochemistry, mRNA and miRNA sequencing, and real-time quantitative polymerase chain reaction (qRT-PCR) validation, we found that in prenatally irradiated (100 mGy/d for 18 days with an accumulative dose of 1.8 Gy) 1-year-old mice, no cellular changes, including immature neurons in the subgranular zone, mature neurons and glial cells in the hilus of the dentate gyrus and development of cognitive impairment, neuropsychiatric disorders, occurred. However, a significant reduction in body weight and mass index (BMI) was indicated by the SHIRPA test. A reduced exploratory behavior was shown by an open field test. Organ weights showed significant reductions in the testes, kidneys, heart, liver and epididymides with no abnormal pathology. mRNA and miRNA sequencing and qRT-PCR validation revealed the upregulation of Rubcnl and Abhd14b, and downregulation of Hspa1b, P4ha1, and Banp genes in both the hippocampus and blood of mice prenatally irradiated with 100 mGy/d. Meanwhile, downregulation of miR-448-3p and miR1298-5p in the hippocampus, miR-320-3p, miR-423-5p, miR-486b-5p, miR-486b-3p, miR-423-3p, miR-652-3p, miR-324-3p, miR-181b-5p, miR-let-7b, and miR-6904-5p in the blood was induced. The target scan revealed that Rubcnl is one of the miR-181b-5p targets in the blood. We, therefore, concluded that prenatal chronic irradiation with a low dose rate of 100 mGy/d and accumulative dose of 1.8 Gy or below might not induce significant adverse health effects on the offspring. Further study of different low dose rate radiation exposures with accumulative high doses may provide threshold doses for authorities or regulators to set new radiation safety guidelines to replace those extrapolated from acute high dose/dose rate irradiation to reduce unnecessary emergency evacuation or spending once a nuclear accident or leakage occurs.

A IMPORTÂNCIA NA MUDANÇA NO ESTILO DE VIDA PARA PACIENTES COM DIABETES MELLITUS TIPO 2 E HIPERTENSÃO ARTERIAL SISTÊMICA: UM RELATO DE CASO

Introduction: Inadequate lifestyle habits, such as poor diet, physical inactivity, and visceral obesity, are directly related to chronic non-communicable diseases like diabetes and systemic arterial hypertension, as well as cardiovascular outcomes. Objective: To report the case of a patient with hypertension and diabetes with poor adherence to non-pharmacological treatment. Methodology: Case report developed in the PIESC Axis of the 7th semester of the Medical Course, involving a 58-year-old male patient with systemic arterial hypertension and diabetes for 20 years. Results: The patient, with a history of stroke and family history of diabetes, has a diet high in salt, fat, and carbohydrates, and does not regularly consume fruits and vegetables. He does not engage in physical activities and is a smoker. During the physical examination, he presented with blood pressure of 135/85 mmHg, heart rate of 88 bpm, body mass index of 30.8, and fasting blood glucose of 200 mg/dl. The importance of lifestyle changes was reinforced, and medication doses were adjusted. Conclusion: The patient has high-risk factors, such as hypertension, age over 55, and a history of smoking. Adherence to non-pharmacological treatment is essential to control modifiable risk factors and improve long-term adherence. Reducing body mass index and abdominal circumference, along with a healthy diet, is crucial. Regular physical activity and diet play an essential role in controlling diabetes. It is crucial for health professionals to emphasize the importance of treatment adherence and the quality of life of patients.

Effect of aerobic and resistive exercise on lipid profile and quality of life in overweight breastfeeding women: A randomized controlled trial.

Breastfeeding provides benefits for both mothers and babies. However, many women experience postpartum weight gain, unfavorable lipid profiles, and other postpartum problems that can adversely impact their overall quality of life (QoL). To examine the effect of adding aerobic and resistive exercise to faradic stimulation and nutritional counseling on lipid profile and QoL in overweight breastfeeding women. Fifty-four breastfeeding women were randomly allocated into two equally sized groups. Group A underwent abdominal faradic stimulation along with nutritional counseling for 12weeks, whereas Group B received identical faradic stimulation and nutritional counseling and engaged in a combined aerobic and resistive exercise program for the same duration. Before and after treatment, the following anthropometric measurements were evaluated: body mass index (BMI), waist-to-hip ratio (W/H); lipid profile analysis, such as high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG); and the Short Form 36 Health Survey Questionnaire (SF-36). All outcome measures demonstrated significant improvements within the two groups (p<0.05). Group B showed more significant reductions in BMI, W/H ratio, and LDL, along with greater significant increases in the SF-36 domain scores for physical functioning, physical health problems, bodily pain, general health, energy/fatigue, social activity, mental health, and the total SF-36 score (p<0.05) compared to group A post-treatment. However, there were no significant differences in HDL, TG, and the score of the emotional wellbeing domain of the SF-36 between the groups after treatment (p>0.05). 12-week aerobic and resistive exercise is effective in reducing the BMI, W/H ratio, and LDL levels and enhancing the QoL in overweight breastfeeding women.

Effectiveness of the Life Enhancement and Advancement Program for Weight Management in Overweight and Obese Females.

Obesity has been shown to have many deleterious physical and psychological consequences. This study examined the effectiveness of adding the Life Enhancement and Advancement Program (LEAP) to a weight management program. To evaluate the different components of a weight loss program, this study included four groups: (1) dieting, exercise, and LEAP; (2) dieting, exercise, and sham training; (3) dieting and exercise; and (4) exercise only. An assessment was administered at baseline, post-intervention, and a three-month follow-up. Forty female participants with a body mass index (BMI) ≥ 25 were recruited from a local sports center. They provided informed consent and were randomly assigned to one of the four groups. Participants' heights were recorded at baseline, and their weight, waist circumference (WC), and BMI were measured at each of the three assessments. Participants completed the Personal Concerns Inventory (PCI) to assess their adaptive motivation at all three assessments. A MANCOVA indicated that participants who received LEAP along with dieting and exercise had a greater reduction in BMI and WC and improved more in adaptive motivation than the other groups. The results suggest that adding LEAP to a weight management program enhanced participants' ability to achieve and maintain weight loss. LEAP enabled participants to pursue and achieve their important goals successfully.

The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: A meta-analysis of randomized controlled trials

BackgroundThe efficacy of GLP1 receptor agonists (GLP1-RAs) in treating polycystic ovarian syndrome (PCOS) remains unclear. While GLP1-RAs are known to promote weight loss in patients with diabetes and living with obesity, their impact on weight reduction and hormonal regulation in women with PCOS is understudied. Therefore, we aimed to assess the efficacy of GLP1-RAs in PCOS women living with obesity through a meta-analysis, comparing their effects to placebo. HypothesisThe use of GLP1-RAs in PCOS women living with obesity can reduce body mass index and waist circumference as well as improve hyperinsulinism, and hyperandrogenism as well as normalize total testosterone, total cholesterol and HOMA-IR markers in PCOS women living with obesity. MethodsWe systematically searched the PubMed, Cochrane Central, Scopus and Embase databases to identify randomized controlled trials (RCT) comparing GLP1-RAs versus placebo among women diagnosed with PCOS based on the Rotterdam Criteria. Our primary outcomes of interest included body mass index (BMI), triglycerides, waist circumference, total testosterone, total cholesterol, and HOMA-IR. We performed data extraction and quality assessment for studies that met the inclusion criteria. We pooled mean difference (MD) and 95 % confidence intervals (CI) with a random-effect model for continuous endpoints. ResultsWe included 176 participants from four RCTs. Semaglutide and Liraglutide were used in 23 (13 %) and 103 (58 %) participants, respectively. GLP1-RAs use was associated with a significant reduction in waist circumference (MD: −5.16 cm; 95 % CI: −6.11 to −4.21; p ˂ 0.00001), body mass index (BMI) (MD: −2.42; 95 % CI: −3.10 to −1.74; p ˂ 0.00001), serum triglycerides (MD: −0.20; 95 % CI: −0.30 to −0.11; p ˂ 0.00001) and total testosterone levels (MD: −1.33; 95 % CI: −2.55 to −0.12; p = 0.03) when compared to placebo. There was no significant difference in total cholesterol (MD: −0.04; 95 % CI: −0.10 to 0.01; p = 0.15) and HOMA-IR (MD: −0.30; 95 % CI: −0.92 to 0.32; p = 0.35) levels. Adverse events information was available for 112 patients, where 49 had light side effects such as nausea and abdominal pain. ConclusionThe use of GLP1-RAs demonstrates efficacy in reducing BMI, triglycerides, waist circumference and total testosterone. There was no significant difference in total cholesterol and HOMA-IR levels. These results signify its viability as a favourable treatment option for managing PCOS symptoms in women living with obesity.

Clinical Effects of Glucagon-Like Peptide-1 Agonist Use for Weight Loss in Women With Polycystic Ovary Syndrome: A Scoping Review.

Glucagon-like peptide-1 (GLP-1) is a gastrointestinal regulatory hormone that stimulates insulin release from the pancreas. While GLP-1 receptor agonists (GLP-1 RAs) have traditionally been utilized to address insulin resistance, their potential application in treating polycystic ovary syndrome (PCOS) has recently garnered attention. This study aimed to investigate the therapeutic efficacy of GLP-1 RAs use for weight loss in women diagnosed with PCOS. We conducted a scoping review following the Joanna Briggs Institute (JBI) methodology and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our investigation delved into the clinical effects experienced by women of diverse racial and ethnic backgrounds with PCOS who were prescribed GLP-1 RAs for weight loss. Peer-reviewed articles from Ovid Medline, Web of Science, CINAHL, Cochrane CENTRAL, SCOPUS, and ClinicalTrials.gov spanning from 2012 to 2023 were scrutinized. After eliminating duplicates, 811 articles were identified, and ultimately, eight met the eligibility criteria for inclusion. All studies were published in English and exhibited wide geographic diversity. The included studies uniformly reported reductions in weight and body mass index (BMI) among patients who were prescribed GLP-1 RAs, specifically liraglutide or exenatide. Additionally, evidence pointed towards improvements in anthropometric parameters (MF1) (including total body weight, BMI, reduction in waist circumference, and total fat percentage), glucose homeostasis, cardiovascular inflammatory markers (midregional pro-atrial natriuretic peptide (MR-proANP) and mid-regional pro-adrenomedullin (MR-proADM)), rates of pregnancy, and menstrual regulation. However, findings regarding the impact of GLP-1 RAs on lipid profiles were inconsistent. Although some short-term adverse effects were noted, long-term effects of GLP-1 RAs use remain undetermined. GLP-1 RA use demonstrated promising clinical outcomes for women with PCOS, including reduced BMI, improved metabolic parameters, menstrual regularity, and increased rates of natural pregnancy. While the current evidence is encouraging, further research is warranted to elucidate both short- and long-term adverse effects of GLP-1 RAtherapy for PCOS.

Effects of auricular stimulation on weight- and obesity-related parameters: a systematic review and meta-analysis of randomized controlled clinical trials.

Over the last three decades, the number of randomized controlled trials (RCTs) using stimulation of auricular vagal sensory nerves by means of electrical stimulation, auricular acupuncture, or acupressure to support weight loss has increased markedly. This systematic review focuses on the effects of auricular stimulation (AS) on anthropometric parameters and obesity-related blood chemistry. The following databases were searched until November 2021: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. Data collection and analysis were conducted by two reviewers independently. Quality and risk assessment of included studies was performed using the risk of bias tool of the Cochrane Handbook, and the meta-analysis of the effect of the most frequently assessed biomarkers was conducted using the statistical software RevMan. The full texts of 1,274 studies were screened; 22 contained data on obesity-related outcomes, and 15 trials with 1,333 patients were included in the meta-analysis. The overall quality of the included trials was moderate. AS significantly reduced body mass index (BMI) (mean difference (MD) = -0.38 BMI points, 95% CI (-0.55 to -0.22), p < 0.0001), weight (MD = -0.66 kg, 95% CI (-1.12 to -0.20), p = 0.005), waist circumference (MD = -1.44 cm, 95% CI (-2.69 to -0.20), p = 0.02), leptin, insulin, and HOMA insulin resistance compared to controls. No significant reduction was found in body fat, hip circumference, ratio of waist/hip circumference, cholesterol, LDL, triglycerides, adiponectin, ghrelin, and glucose levels. The AS was safe throughout the trials, with only minor adverse reactions. The study results suggest that a reduction of weight and BMI can be achieved by AS in obese patients; however, the size of the effect does not appear to be of clinical relevance. The effects might be underestimated due to active sham trials. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231885.

An open-label 16-week study of liraglutide in adolescents with obesity post-sleeve gastrectomy.

Up to 50% of adolescents who undergo metabolic and bariatric surgery (MBS) have obesity 3 years post-MBS, placing them at continued risk for the consequences of obesity. We conducted an open-label, 16-week pilot study of liraglutide in adolescents with obesity after sleeve gastrectomy (SG) to investigate liraglutide effects on weight and body mass index (BMI) post-SG. Adolescents aged 12-20.99 years with obesity and a history of SG ≥1 year prior were enrolled. Liraglutide was initiated at 0.6 mg/day, escalated weekly to a maximum of 3 mg/day, with treatment duration 16 weeks. Fasting laboratory assessments and an oral glucose tolerance test were performed at baseline and end-treatment. A total of 43 participants were screened, 34 initiated liraglutide (baseline BMI 41.2 ± 7.7 kg/m2), and 31 (91%) attended the end-treatment visit. BMI decreased by 4.3% (p < 0.001) with liraglutide. Adolescents who had poor initial response to SG (<20% BMI reduction at BMI nadir) had less weight loss with liraglutide. Fasting glucose and haemoglobin A1C concentrations significantly decreased. There were no serious treatment-emergent adverse events reported. Liraglutide treatment was feasible and associated with a BMI reduction of 4.3% in adolescents who had previously undergone SG, quantitatively similar to results obtained in adolescents with obesity who have not undergone MBS.